Kaiser Permanente Intern Request Application
2017 Summer Intern Request Form- Please Complete by April 1st
Department Information
Company Name *
Your answer
Hiring Manager Name *
Your answer
Title *
Your answer
Email *
Your answer
Department *
Your answer
Location/Facility Name
Your answer
Office Address (include street, state, and zip code) *
Your answer
Alternate Contact Information
Name and Title
Your answer
Phone Numbrer
Your answer
Email Address
Your answer
Intern Manager Information (if not hiring manager)
Name and Title
Your answer
Phone Number
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Email
Your answer
About Hosting an Intern
Thank you for your interest in the Kaiser Permanente Youth Leadership Program Internship. This six week paid internship program gives rising seniors and recent college graduates the opportunity to gain 'real world' experience. Selecting the right project is essential to ensuring your intern has the best experience. Please consider determining clear goals and outcomes that are achievable within a six week period, interesting and challenging assignments that build transferable skills, and opportunities to interact with both small and large teams in the office.
Position Profile
Please complete all sections below as this information is critical for identifying qualified candidates
Brief Description of your Department and/or Organization's Function *
Your answer
Description of major project(s) that the intern will be responsible for completing during the internship (please consider more than one project) *
Your answer
Has your office ever had an intern before? If so, please elaborate. *
Your answer
List specific qualities, knowledge, and abilities that you are looking for in an intern. *
Your answer
Is your office accessible by public transit? If so, what kind (bus/train, etc) and what bus line or train stop is closest to you? *
Your answer
How many interns are you able to host over the summer? *
Your answer
Any other comments or information we should have?
Your answer
All Intern Request Forms must be submitted by COB Friday, March 31st, 2017.
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